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Polycythemia is a state in which there are excessive red blood cells (RBC) in circulation. Etiologies of polycythemia can be categorized into primary and secondary causes. Primary polycythemia, known as polycythemia vera, is a disease of abnormally increased erythropoiesis by the bone marrow as a result of a genetic defect. Secondary polycythemia is mediated by erythropoietin (EPO) secretion. High altitude, smoking, lung diseases, and cardiovascular diseases are common causes of hypoxemia leading to EPO secretion and, consequently, secondary polycythemia

Dear Editor: With great interest we read the article by Thanapaisan et al. 1 The purpose of this study was to investigate the occurrence of polycythemia in pilots and identify associated risk variables. A descriptive cross-sectional study was carried out in 2018 at the Royal Thai Air Force Institute of Aviation Medicine in Bangkok, Thailand. Data were gathered from both paper and computer-based medical records of pilots seeking a Class 1 Flight Medical Certificate. Of the 386 records examined, 29 pilots (7.5%) satisfied the polycythemia criterion

( Fig. 1 ). Therefore, the newborn was transferred to a neonatal intensive care unit, where continuous positive airway pressure was administered. In addition, blood test results showed high levels of hemoglobin (Hb; 23.1 g · dL −1 ) and hematocrit (Hct; 69.2%), indicating polycythemia. During hospitalization, Hb and Hct levels increased to 24.2 g · dL −1 and 70.0%, respectively ( Fig. 2 ). Echocardiography revealed patent ductus arteriosus and mild pulmonary arterial hypertension. Despite adjustments to the ventilation strategy, the newborn’s respiratory distress